Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $125.89	Facility		$109.65	$109.65	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $109.65	Professional		$56.23	$72.44	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $154.88 / $389.05	Facility		$123.03	$154.88	$389.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $501.19 / $501.19	Professional		$162.18	$501.19	$501.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $389.05 / $588.84	Professional		$223.87	$389.05	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $141.25	Facility		$138.04	$138.04	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $138.04	Professional		$102.33	$102.33	$138.04
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $204.17	Professional		$169.82	$169.82	$204.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $302.00 / $457.09	Professional		$239.88	$302.00	$457.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $954.99 / $954.99	Professional		$831.76	$954.99	$954.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $147.91 / $229.09	Facility		$56.23	$147.91	$229.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $138.04	Professional		$102.33	$102.33	$138.04
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $288.40	Professional		$169.82	$223.87	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $74.13 / $89.13	Facility		$12.30	$74.13	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $74.13 / $158.49	Professional		$58.88	$74.13	$158.49